The Power of Collaboration: - PowerPoint Presentation

1. The Power of Collaboration: Success Stories of Harm Reduction and Public Safety Partnerships to Prevent OverdoseThursday, November 9th, 2023| 3:00 – 4:30 pm ET

2. HousekeepingYou will be muted automatically upon entry and for the duration of the webinar. This webinar is being recorded and will be archived for future viewing on the National Council’s website. Please submit your questions using the Q&A box at the bottom of the screen.

3. Frequently Asked QuestionsThis webinar will be recorded and will be made available to view on demand, along with a copy of these slides, within 3 days following the event’s conclusion.This webinar is not CEU accredited. There will not be a certificate of completion for attending this webinar. However, if you would like proof of attendance for your employer, please email WSloyer@thenationalcouncil.org and we would be happy to provide you with an email verification.

4. Today’s PresentersDeputy Chief of Police Jeffrey FilzekMadison Heights Police DepartmentCaroline DavidsonDirector,National Council for Mental WellbeingDunya BarashDirector of Operations,Families Against NarcoticsJudge Linda DavisFamilies Against NarcoticsNeil Calmjoy, LICSWProgram Manager,Catholic Community Services of Western WashingtonCarolina Hershey, CPCPrevention Case Manager/ Certified Peer Counselor,Catholic Community Services of Western Washingtonand Joel CohenConsultant with the National Council for Mental Wellbeingas Panel ModeratorTeal GardnerCrisis Response Unit Lead,Olympia Police Department

5. Project OverviewThe National Council for Mental Wellbeing (National Council), with support from the Centers for Disease Control and Prevention (CDC), invited organizations to apply for grant funding to support one-year pilot projects integrating harm reduction strategies and public safety initiatives. Pilot Project Goals: Support the implementation and enhancement of evidence-based or promising strategies to prevent and reduce overdose and other drug-related harms through collaborations with public safety (e.g., naloxone and fentanyl test strip (FTS) distribution and linkages to primary care, mental health care, evidence-based treatment for SUDs and other support services). Integrate harm reduction strategies and public safety initiatives to prevent and reduce overdose risk and other harms for people who use drugs (PWUD) and people with substance use disorders (PWSUD).This project is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,000,000 with 100% funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS or the U.S. Government.

6. AgendaBackground Overview and history of harm reductionHistoric areas of tension between harm reduction and public safetyPanelist presentationsPanelist discussion and Q&AActionable takeawaysLessons learned and recommendations from panelistsPreview of upcoming resources from the National Council

7. BackgroundHarm Reduction Basics and the Intersections of Harm Reduction and Public Safety

8. Tackling Fatal Overdose and Substance Use DisorderPreventionTreatmentRecovery SupportHarm Reduction

9. Harm ReductionMeeting people where they’re at, but not leaving them thereRecognizing that change is a process and helping people in their journey along that process without judgmentHarm reduction is…“…a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.”“…a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.”In particular, harm reduction “emphasizes kindness and autonomy in the engagement of people who use drugs.”Sources:National Harm Reduction Coalition. 2019. “Principles of Harm Reduction.” Harmreduction.org. https://harmreduction.org/about-us/principles-of-harm-reduction/.Substance Abuse and Mental Health Services Administration. 2023. “Harm Reduction.” https://www.samhsa.gov/find-help/harm-reduction

10. Pillars of Harm Reduction Want to know more? Substance Abuse and Mental Health Services Administration. 2023. Harm Reduction Framework. https://www.samhsa.gov/sites/default/files/harm-reduction-framework.pdf Harm reduction…Is guided by people who use drugs (PWUD) and with lived experience of drug useEmbraces the inherent value of peopleCommits to deep community engagement and community buildingPromotes equity, rights, and reparative social justiceOffers lowest barrier access and non-coercive supportFocuses on any positive change, as defined by the person

11. naloxone distributionhousing-first programsfentanyl test stripsmethadone and buprenorphine*syringe exchange/ distributionsafe consumption spacesbridge programs (low barrier linkage to treatment and/or medication)peer support programsrisk reduction educationnavigation servicesnon-punitive approach to return to usewound caretesting and prevention for infectious disease (such as HIV and viral hepatitis)Examples of harm reduction practices include…

12. Ultimately…Harm reduction can encompass many different pieces.These grant projects were focused specifically on overdose prevention and risk reduction related to substance use, which will largely be the focus of this presentation.

13. Harm Reduction (Mini) HistoryFrom In the Works

14. Areas of Tension Between Harm Reduction and Public SafetyCollective stigma may lead to public viewing substance use or substance use disorder as an issue that should be tackled by public safety (rather than a systemic need)Harm reduction services that help people who use drugs (PWUD) may be illegal or not completely legalPublic safety are generally available 24 hours a day, and may therefore be a measure of last resort to address social challengesPolicies have historically penalized PWUD, so interactions with public safety may be colored by this historic patternPWUD may have had previous negative experiences with public safety, which could contribute to their or their peers’ tensionsPublic safety may be frustrated with what they see as “revolving door” – PWUD who deal with consequences of substance use and then choose to use again

15. Comeback Quick Response Team (QRT)Families Against Narcotics (FAN)Dunya BarashJudge Linda DavisDeputy Chief of Police Jeffrey Filzek

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19. Arrest and Jail Alternatives (AJA)Catholic Community Services of Western WashingtonNeil Calmjoy, LICSWCarolina Hershey, CPC

20. Program OverviewArrest & Jail Alternatives works with Public Safety partners to engage justice-impacted individuals in case management to reduce recidivism.Individuals referred are often at the intersection of homelessness, substance use disorder, and unmet behavioral health needs.Participants work with Peer Case Managers who utilize their training and lived experience to build rapport and assist with navigating complex systems.

21. Partnership with Public SafetyReferral Criteria- frequent, high utilizers of First Response entities with MH/SUD needs.AJA Case Managers assist at point of contact when arrest is imminent in order to de-escalate or divert arrest.Collaborate with for additional insight around encounters, behavior, BOLOs, other notable information.Work with courts and jails to provide peer counseling during incarceration and advocacy during legal proceedings.

22. Implementing Harm ReductionPeer Case Managers assist participants in connecting to low barrier housing, medical & mental health services, and MAT services.Also connect participants with recovery goals around access to MAT, syringe services, Naloxone, and other resources.AJA’s work is applied through the belief that being justice impacted is an inherently harmful and traumatic experience to the community we serve.

23. AJA’s Prevention ProgramIn 2023, the National Council funded an AJA subprogram focused on prevention—assisting individuals further upstream, prior to falling into chronic homelessness and behavioral health crisis.Referral Criteria—housed with unmet substance use or behavior health needs, increased contact with Public Safety, possible risk of losing housing.AJA provides short term and intensive case management to assist with stability, strong systems advocacy, and overall reduction in emergency calls.

24. Deputy Chief of Police Jeffrey FilzekMadison Heights Police DepartmentDunya BarashDirector of Operations,Families Against NarcoticsJudge Linda DavisFamilies Against NarcoticsNeil Calmjoy, LICSWProgram Manager,Catholic Community Services of Western WashingtonCarolina Hershey, CPCPrevention Case Manager/ Certified Peer Counselor,Catholic Community Services of Western WashingtonTeal GardnerCrisis Response Unit Lead,Olympia Police DepartmentPanelist Discussion & Q&APlease submit your questions using the Q&A box at the bottom of the screen. and Joel CohenConsultant with the National Council for Mental Wellbeingas Moderator

25. Thank You!Caroline DavidsonNational Council for Mental WellbeingDunya BarashFamilies Against NarcoticsJudge Linda DavisFamilies Against NarcoticsDeputy Chief of Police Jeffrey FilzekMadison Heights Police DepartmentNeil Calmjoy, LICSWCatholic Community Services of Western WashingtonCarolina HersheyCatholic Community Services of Western WashingtonTeal GardnerOlympia Police DepartmentJoel CohenConsultant with the National Council for Mental Wellbeinghttps://www.surveymonkey.com/r/BYNNVVQ

26. Appendix

27. Why Harm Reduction? Quality of life benefitsHarm reduction can:Reduce stigma associated with substance use and co-occurring disorders.Promote a philosophy of hope and healing ― by employing people with living and lived experience in leadership and in the planning, implementation, and evaluation of services. People with lived experience can also model meaningful change for their peers.Build community and increase protective factors ― for people who use drugs and their families.Encourage client autonomy.Source: Substance Abuse and Mental Health Services Administration. 2023. Harm Reduction Framework. https://www.samhsa.gov/sites/default/files/harm-reduction-framework.pdf

28. Why Harm Reduction?Physical health benefitsHarm reduction programs have been associated with:Reducing the risk of spreading infections related to substance use1 (in particular, HIV and hepatitis C2) Increasing referrals to substance use disorder (SUD) treatment3,4 Reducing hospital visits5Wilson, D. P., Donald, B., Shattock, A. J., Wilson, D., & Fraser-Hurt, N. (2015). The cost-effectiveness of harm reduction. International Journal of Drug Policy, 26 Suppl 1:S5-11. doi:10.1016/j.drugpo.2014.11.007Puzhko, S., Eisenberg, M. J., Filion, K. B., et al. (2022). Effectiveness of interventions for prevention of common infections among opioid users: A systematic review of systematic reviews. Frontiers in Public Health, 2022;10:749033. doi:10.3389/fpubh.2022.749033Strathdee, S., & Vlahov, D. (2001). The effectiveness of needle exchange programs: A review of the science and policy. AIDScience. 2001:1Surratt, H. L., Otachi, J. K., Williams ,T., Gulley, J., Lockard, A. S., & Rains, R. (2020). Motivation to change and treatment participation among syringe service program utilizers in rural Kentucky. Journal of Rural Health, 2020; 36(2):224-233. doi:10.1111/jrh.12388Coye, A. E., Bornstein, K. J., Bartholomew, T.S., et al. (2021). Hospital costs of injection drug use in Florida. Clinical Infectious Diseases 2021;72(3):499-502. doi:10.1093/cid/ciaa823

29. Why Harm Reduction? System benefitsHarm reduction programs have also been shown to:Be cost effective by resulting in fewer instances of infectious disease, ambulance calls, emergency department visits, hospital stays and overdose death.6-9 Advance health equity and have the potential to address racial disparities.10Ijioma, S. C,. Pontinha, V. M., Holdford, D. A., & Carroll, N. V. (2021). Cost-effectiveness of syringe service programs, medications for opioid use disorder, and combination programs in hepatitis C harm reduction among opioid injection drug users: A public payer perspective using a decision tree. Journal of Managed Care and Specialty Pharmacology. 2021;27(2):137-146. doi:10.18553/jmcp.2021.27.2.137Cousien, A., Tran, V. C., Deuffic-Burban, S., et al. (2018). Effectiveness and cost-effectiveness of interventions targeting harm reduction and chronic hepatitis C cascade of care in people who inject drugs: The case of France. Journal of Viral Hepatitis. 2018;25(10):1197-1207. doi:10.1111/jvh.12919Ritter, A., & Cameron, J. (2006). A review of the efficacy and effectiveness of harm reduction strategies for alcohol, tobacco and illicit drugs. Drug and Alcohol Review. 2006;25(6):611-624. doi:10.1080/09595230600944529Pollack, H. A. (2001). Cost-effectiveness of harm reduction in preventing hepatitis C among injection drug users. Medical Decision Making. 2001;21(5):357-367. doi:10.1177/0272989X0102100502Vearrier, L. (2019). The value of harm reduction for injection drug use: A clinical and public health ethics analysis. Disease-a-Month. 2019;65(5):119-141. doi:10.1016/j.disamonth.2018.12.002

30. Ultimately…You can’t help someone recover if they’re not alive.

31. Emerging Trends in Harm ReductionSpread of safe consumption spacesDecriminalization of fentanyl test stripsNaloxone approval for over-the-counter purchaseWidespread naloxone availability (in schools and beyond)Increase in medication accessibility (telehealth expansion, mobile units, updated limits on prescribing)Adapted strategies for emerging drugsNovel partnershipsIncrease in housing-first programsIntentionally incorporating peer work into non-peer spaces